Electroacupuncture at the Renzhong (DU 26) and Neiguan (PC 6) acupoints repairs the DNA of nervous tissue supplied by the middle cerebral artery in rats

This study compares the changes of DNA repair in brain tissue dominated by the middle cerebral artery after electroacupuncture at the acupoints of Renzhong （DU 26）, Neiguan （PC 6）, Quchi （LI 11） and Zusanli （ST 36） in rats. In the apurinic/apyrimidinic endonuclease DNA basic group reparative excision experiments, the apurinic/apyrimidinic endonuclease activity of brain tissue increased slightly after electroacupuncture in rats. In the DNA polymerase β （Pol β）experiments, the Pol β ac-tivity of brain tissue increased after electroacupuncture, especially at DU 26 and PC 6. In the DNA ligase experiments, the expression of DNA ligase 1 in brain tissue increased significantly after electroacupuncture. These findings demonstrate increased activity of apurinic/apyrimidinic en-donuclease, Pol β and DNA ligase 1 after electroacupuncture at DU 26 and PC 6. Also, DNA repair in brain tissue supplied by the middle cerebral artery is promoted after electroacupuncture at DU 26 and PC 6, which are more effective than the LI 11 and ST 36 acupoints .

Effect of electroacupuncture at Neiguan(PC6)at different time points on myocardial ischemia reperfusion arrhythmia in rats

OBJECTIVE:To observe the effects of electroacupuncture at Neiguan(PC6)at different time points on reperfusion arrhythmia(RA)after myocardial ischemia and reperfusion in rats,and to investigate the correlation of this protective effect with nerve growth factor(NGF),tyrosine kinase A(Trk A),tyrosine hydroxylase(TH),and norepinephrine(NE).METHODS:A total of 72 Sprague-Dawley male rats were randomly divided into six groups(n=12 rats/group):normal group(Norm),sham operation group(Sham),ischemia reperfusion group(I/R),pre-ischemic electroacupuncture group(EAI),pre-reperfusion electroacupuncture group(EAII),post-reperfusion electroacupuncture group(EAIII).The myocardial ischemia-reperfusion injury(MIRI)model was induced by occlusion of left anterior descending coronary artery for 20 min followed by reperfusion for 40 min in rats.With no intervention in the Norm group and only threading without ligation in the Sham group.Electroacupuncture pretreatment at 20 min/d for 7 d before ligation in the EAⅠgroup,20 min of electroacupuncture before reperfusion in the EAII group and 20 min of electroacupuncture after reperfusion in the EAIII group.The electrocardiogram(ECG)of each group was recorded throughout the whole process,and the success of the MIRI model was determined based on the changs of J-point and T-wave in the ECG.The arrhythmia score was used to record premature ventricular contractions,ventricular tachycardia and ventricular fibrillation during the reperfusion period to assess the reperfusion induced arrhythmias.The expression levels of NGF,Trk A,TH protein were measured by Western blot.Moreover,the expression levels of plasma and myocardial NE levels were detected by enzyme linked immunosorbent assay.RESULTS:The differences between Norm group and Sham group were not statistically significant in all indexes.Arrhythmia score,myocardial NGF,Trk A,TH,and NE expression were significantly higher in the I/R group compared with the Sham group.Arrhythmia score,myocardial NGF,Trk A,TH,and NE expression were significantly lower in each EA group compared with the I/R group.CONCLUSION:Electroacupuncture at Neiguan(PC6)at different time points can reduce the incidence and severity of reperfusion arrhythmias in rats.This protective effect is related to electroacupuncture regulating NGF,Trk A,TH,NE expression and reducing sympathetic hyperactivation.

Effect of Acupuncture at Acupoint Neiguan(PC6)on the Myocardial c-fos Gene Expression of Acute Myocardial Ischemia in Rats

Objective：To investigate the mechanism of improvement effect of electro acupuncture at acupoint Neiguan （PC 6） on acute myocardial ischemia （AMI）. Methods： Ninety-six rats were randomly divided into sham-operation group, myocardial ischemia model group and myocardial ischemia model plus electro-acupuncture group, the rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then electro-acupuncture therapy was performed at bilateral acupoint Neiguan （PC 6）. The myocardial enzyme activities in plasma was detected with biochemical method, and the myocardial c-fos gent expression was detected with reverse transcription polymerase chain reaction（RT PCR） method. Results： The myocardial enzyme activities in plasma and the myocardial c-fos gene expression in myocardial ischemia model group were obviously higher than those in sham group（P〈 0.05）, after electro-acupuncture treatment, the myocardial enzyme activities in plasma and the myocardial c-fos gene expression were decreased, there was a significant difference （P〈 0.05）. Conclusion. The mechanism of improvement effect of electro acupuncture at acupoint Neiguan （PC 6） on AMI is related to down-regulation of the myocardial c-fos mRNA expression.

Efficacy on rabbits with arrhythmia: needling acupoint of Neiguan(PC6) at shallow or deep depth, and retaining needles for 10, 20, or 30 min

OBJECTIVE:To compare the effects of Neiguan(PC6)acupuncture at different depths and retention time on arrhythmia duration,myocardial tissue morphology,mRNA expression level of L-type calcium channelα1C subunit and Ca^(2+)-Mg^(2+)-At Pase activity in tachirrhythmia model of rabbits.METHODS:The tachyarrhythmia model was made by intravenous injection of barium chloride into the ears of rabbits.A total of 56 healthy adult male New Zealand big-eared white rabbits,apply the random number table method,divided into normal control group(group A),model group(group B),shallow needling Neiguan(PC6)10 min group(group C),shallow needling Neiguan(PC6)20 min group(group D),shallow needling Neiguan(PC6)30 min group(group E),deep needling Neiguan(PC6)10 min group(group F),deep needling Neiguan(PC6)20 min group(group G),deep needling Neiguan(PC6)30 min group(group H),7 animals in each group.Electrocardiograms were used to collect the duration of arrhythmia;hematoxylin-eosin staining method was performed on myocardial tissue,RT-PCR tested the expression ofα1C subunit mRNA,and the activity of Ca^(2+)-Mg^(2+)-ATPase were quantified by phosphorus determination method.RESULTS:The duration of arrhythmia in each acupuncture treatment group was shortened to varying degrees.Compare to the model group,the tissue damage from barium chloride inducing was improved in the acupuncture group.Compared to the model group,except for group E,most treatment groups had varying degrees of improvement with significantly down-regulated L-type calcium channelα1C subunit mRNA expressions level and increased Ca^(2+)-Mg^(2+)-ATPase activity.CONCLUSIONS:The effect of acupuncture at Neiguan(PC6)with different depths and retention time can reduce the duration of arrhythmia induced by barium chloride relatively,improve the induced pathological changes,down regulate L-type calcium channelα1C subunit mRNA expressions level and increase Ca^(2+)-Mg^(2+)-ATPase activity.Both the shallow and deep tissues of Neiguan(PC6)may be involved in transmitting acupuncture information.There is an optimal induction period for shallow needling at Neiguan(PC6)to reach the best therapeutic effect.

Effect of electronic stimulation at Neiguan(PC 6) acupoint on gene expression of adenosine triphosphate-sensitive potassium channel and protein kinases in rats with myocardial ischemia

OBJECTIVE:To investigate the effects of electronic stimulation at acupoints Neiguan(PC 6) and Lieque(LU 7) on the gene expression of the adenosine triphosphate(ATP)-Sensitive potassium channel(KATP:Kir6.1,Kir6.2,SUR2 A,and SUR2B) and protein kinases(PKA,PKG,and PKCβ2) in myocardial cells of rats with myocardial ischemia(Ml) induced by isoproterenol(ISO).METHODS:Rats were randomly divided into a control,model,Neiguan(PC 6),Lieque(LU 7),and non-acupoint groups.The Ml model was established by injecting rats with ISO.Electro-acupuncture treatment was given to the acupuncture groups,once a day for 7 days.Gene expression was analyzed with real-time PCR.RESULTS:The gene expression of KATP and protein kinases in the model group was higher than those in the control group(P < 0.05).After acupuncture treatment,the KATP and protein kinase expression levels were significantly lower in the Neiguan(PC 6)and Lieque(LU 7) groups compared with the model group[P < 0.05).The Neiguan(PC 6) group lowered these levels significantly more than that of the Lieque(LU 7) group(P < 0.05).No significant differences were observed between the model and non-acupoint groups(P > 0.05).CONCLUSION:Our findings suggest that electronic needling of Neiguan(PC 6) can both reduce the gene expression of KATP and protein kinases in rats with ISO-induced Ml.

Clinical Application of Acupoint Neiguan (PC 6)

Acupoint Neiguan (PC 6) is first recorded in LingShu (Spritual Pivot). It is the Luo-Connecting pointof the Pericardium Meridian and communicateswith acupoint Waiguan (TE 15); it is also one ofeight confluent points, and associates with the YinLink Vessel. We often use Neiguan (PC 6) alone oras the cardinal acupoint to treat many disorders inclinical practice. It is now reported as follows.

CLINICAL APPLICATION OF NEIGUAN (内关 PC 6) IN THE TREATMENT OF DISORDERS OF THE DIGESTIVE SYSTEM——THE RELATED RESEARCH PROGRESS

In the present paper, the authors review recent situations of clinical application of Neiguan (PC 6内关), etc. in the treatment of disorders of the digestive system and its related research progresses. In clinical practice, Neiguan (PC 6) is usually selected as one of the main acupoints to treat gastrointestinal reactions induced by ① nausea and vomiting, ② hiccup, ③ gastrointestinal dyskinesia, ④ gastritis, and ⑤ intra-gastric examination, cesarean section, etc. Concerning experimental studies, the effects of Neiguan (PC 6), etc. on ① gastric electrical activities, ② gastrointestinal motion, ③ gastrointestinal hormone secretion, and ④ gastric mucosal structure were observed. Results indicated that Neiguan (PC 6) is an important and effective acupoint for treatment of gastrointestinal disorders in clinic. Stimulation of Neiguan (PC 6) induced favorable regulation of both the peripheral nervous system and central nervous system, and changes of the gastrointestinal hormone secretion may contribute to its effects in treating various disorders.

NEIGUAN(PC 6) BLOCKING FOR PREVENTING NAUSEA AND VOMITING CAUSED BY SUBARACHOID MORPHINE ANALGESIA

To find a simple and an inexpensive by method to reduce postoperative nausea and vom iting abbreviated to (PONV) caused subarachoid morphine analgesia. Methods: ninty-eight gyneeco logic patients who took 0. 5 mg morphine by subarahaid space to control postoperative pain, randomly divided into group Ⅰ (n = 50) whose bilateral Neiguan were blocked by 0. 25% bupivacaine 2 ml, group Ⅱ (n= 48), who were intravenously injected ondansetron 4 mg, preoperatively and postopera tively to prevent nausea and vomiting. The numbers of the patients experienced PONV were observed for 48 hrs after operation. Result: group i had 15 patients, group Ⅱ had 14 ones, who experienced ~ (P >0. 05 ), Conclusion: Neiguan blocking can effectively prevnt PONV caused by subara choid morphine anslgesia without side effects.

Influence of Different Acupuncture Method on Points Transcutaneous CO_2 Emission

Objective： To observe the influence of transcutaneous CO2 emission （TCE） at points on the meridian or beside the meridian after different stimulations like acupuncture De-qi, sham acupuncture, study the correlation between acupuncture De-qi and local energy metabolism through TCE. Methods： Twenty healthy volunteers （male 8, female 12, average age 29 years old） were selected. Before, during and after five different acupuncture Neiguan （PC 6）, the TCE was measured at Quze （PC 3）, point A [at the lower one fourth of line between Tianquan （PC 2） and Quze （PC 3）] , point B [at the middle of line between Ximen （PC 4） and Quze （PC 3）], point C （2 cm ulnar side point A） and point D （2 cm ulnar side point B） with a high sensitive CO2 instrument （Frewil-Q.F., made in China）. The measure results were compared. Results： The comparison on value of TCE before and after the acupuncture, in Sham acupuncture and shallow acupuncture groups, it increased in all five points; in De-qi acupuncture group, there are significant increase on point A, point B, and Quze （PC 3）, it has statistic significance, but there are no significant increase on point C and D. After Ximen （PC 4） or Daling （PC 7） were pressed to block Neiguan （PC 6）, the value of TCE on Quze （PC 3）, point A and point B were decreased during acupuncture Neignan （PC 6）, and increased after the block was removed, but there was no significant difference. Conclusion： Sham acupuncture has also some effects on body, it can increase energy metabolism of local skin, it may be the reason that shallow acupuncture without qi arriving can obtain clinical efficacy. The operation method of traditional qi arriving acupuncture can increase energy metabolism of relevant meridian skin, mechanical press can reduce this effect.

Penetration needling on complementary acupoints for insomnia

Objective To observe the comparison of the clinical efficacy between penetration needling from Neiguan （内关 PC 6） to Waiguan （外关 TE 5） and western medicine estazolam for insomnia. Methods Sixty insomnia patients were divided into 2 groups according to the random number table, 30 cases in each group. Penetration needling from PC 6 to TE 5 was mainly adopted in acupuncture group for once a day, 5timesa week, and treatment for 4 weeks was 1 course of treatment. Estazolam was orally given in medicine group before sleep every night in a dosage of 1 mg per time, and treatment for 4 weeks was 2 course of treatment. After 4 weeks, the clinical efficacy and the Pittsburgh Sleep Quality Index （PSQI） score were compared respectively between the two groups. Results The total effective rate was 90.00% in acupuncture group and 63.33% in medicine group, and the difference was statistically significant （P〈0.05）. PSQI score in acupuncture group was （7.93＋3.77）, which was superior to that in medicine group （10.60＋4.20）, and the difference between the two groups was statistically significant （P〈0.05）. Conclusion The penetration needling of complementary acupoints from PC 6 to TE 5 was simple and convenient which can significantly improve the patients＇ sleep quality.

Clinical Study on Acupoint Injection plus Acupuncture for Insomnia Due to Heart-kidney Disharmony

Objective: To observe the clinical efficacy of acupoint injection at Neiguan(PC 6) plus acupuncture in treating insomnia due to heart-kidney disharmony. Methods: A hundred patients with insomnia due to heart-kidney disharmony were randomized into an observation group and a control group. Fifty-three cases in the observation group were intervened by acupoint injection at Neiguan(PC 6) plus acupuncture; while 54 cases in the control group were intervened by acupuncture alone. The Pittsburgh sleep quality index(PSQI) was evaluated before and after intervention, and the therapeutic efficacies of the two groups were compared. Results: Acupoint injection at Neiguan(PC 6) plus acupuncture produced significantly higher efficacies in improving sleep quality, shortening sleep latency, and enhancing sleep efficiency than acupuncture alone(P<0.05).Conclusion: The two groups both can improve the condition of insomnia; acupoint injection at Neiguan(PC 6) has significant advantages, manifested by a higher therapeutic efficacy for insomnia due to heart-kidney disharmony, higher safety evaluation, efficiency, and less adverse events, thus proper for clinical application.

Effects of needling acupoints at different nerve segments on oxytocin neurons in rat’s hypothalamic paraventricular nucleus and intragastric pressure

Objective:To compare and explore the effects of needling acupoints at different nerve segments on the oxytocin(OT)neurons in the paraventricular nucleus of hypothalamus(PVN)and the intragastric pressure,and discuss the possible mechanisms.Methods:Thirty-two healthy adult Sprague-Dawley(SD)rats were numbered and divided into 4 groups according to the random number table,a Zusanli(ST 36)group,a Neiguan(PC 6)group,a Weishu(BL 21)group and a control group,with 8 rats in each group.Except the control group,rats in the other three groups received acupuncture at the corresponding acupoints.To observe the differences in double-labeled OT neurons and c-fos neurons of the hypothalamic PVN and the intragastric pressure after acupuncture among the three groups of needling acupoints at different nerve segments.Results:Compared with the control group,the numbers of double-labeled cells in the PVN of the Zusanli(ST 36)group and the Neiguan(PC 6)group decreased significantly,while the intragastric pressure increased significantly(all P<0.05),and the inter-group differences were statistically significant(P<0.05).The intragastric pressure in the Weishu(BL 21)group decreased significantly,and the inter-group difference was statistically significant(P<0.05).Compared with the Weishu(BL 21)group,the numbers of OT/c-fos double-labeled cells in PVN of the Zusanli(ST 36)group and the Neiguan(PC 6)group decreased significantly,and the intragastric pressure increased significantly,the inter-group differences were statistically significant(all P<0.01).Conclusion:Acupoints at different nerve segments have different regulation effects on intragastric pressure.The difference may be related to the different nerve conduction pathways by acupoints at different nerve segments in regulating the intragastric pressure.The PVN may be one common integration center for the regulation of gastric function in the three acupoints[Zusanli(ST 36),Neiguan(PC 6)and Weishu(BL 21)]at different nerve segments.

Effect of electroacupuncture at Neiguan(PC 6) and Baihui(GV 20) on CHOP and caspase-12 gene expressions in rats after ischemia-reperfusion injury

Objective： To investigate the effects of electroacupuncture （EA） at Neiguan （PC 6） and Baihui （GV 20） by observing the changes of CCAAT/enhancer-binding protein（C/EBP） homologous protein （CHOP） and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury （IRI）, and explore whether the apoptosis pathway of endoplasmic reticulum stress （ERS） is involved in the protective mechanisms of EA. Methods： Sixty rats were randomly assigned to five groups （12 in each group）： a normal control group （group A）, a sham-operation group （group B）, an operation group （group C）, an Edaravone group （group D） and an EA group （group E）. The cerebral IRI rat model was induced by middle cerebral artery occlusion （MCAO） using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride （TTC） staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction （RT-PCR） was used to determine the mRNA expressions of CHOP and caspase-12. Results： Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances （P〈0.05 or P〈O.01）; compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly （P〈0.05 or P〈0.01）; there were no significant differences between group D and group E in comparing the above items （P〉0.05）. Conclusion： EA at Neiguan （PC 6） and Baihui （GV 20） can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan （PC 6） and Baihui （GV 20） is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

针刺内关穴治疗低脉压综合症106例临床观察

平均动脉压正常而脉压差降低，可以产生一系列临床表现，可谓之低脉压综合症。针刺双侧内关穴具有升高收缩压、降低舒张压、增大脉压差并消除相应的临床症状的作用，有效率在９２％以上。

Effect of acupuncture at Neiguan (PC 6) on cardiac function using echocardiography in myocardial ischemia rats induced by isoproterenol

OBJECTIVE: To investigate the effect of acupuncture at Neiguan(PC 6) on cardiac function using echocardiography in rat models of myocardial ischemia(MI) induced by isoproterenol(ISO).METHODS: Twenty-seven Sprague-Dawley rats were randomly assigned to normal, model, and acupuncture groups. The model and acupuncture groups were given injections of ISO(85 mg/kg) to establish the MI model. After model establishment,the acupuncture group was treated with acupuncture at Neiguan(PC 6) for 30 min. Echocardiography was used to monitor diastolic and systolic function for 30 min starting from the time after the acupuncture needles were removed. Changes in the length of left ventricular internal diameter at end-diastole(LVIDd), length of left ventricular internal diameter at end-systole(LVIDs), the ratio of mitral peak velocity at early diastole and atrial contraction(E/A), ejection fraction(EF), fractional shortening(FS), and stroke volume(SV) were measured.RESULTS: Compared with the model group at 0and 15 min after needles were removed, the means of LVIDd and LVIDs were significantly lower(P <0.01) and E/A, EF, FS, and SV significantly higher(P < 0.01) in the acupuncture group. In the acupuncture group, the means of LVIDd and LVIDs15 min after the needles were removed were significantly higher(P < 0.01) than those at 0 min. The means of E/A, EF, FS, and SV significantly decreased(P < 0.01) from 0 to 15 min in the acupuncture group.CONCLUSION: These findings indicate that acupuncture at Neiguan(PC 6) can affect cardiac function by increasing left ventricular diastolic and systolic function in MI rat models, but the effect only lasts for 15 min.

Effect of electroacpuncture of Neiguan(PC 6)and Tianquan(PC 2)on skin temperature,blood perfusion,and adrenoceptor response in rats with acute myocardial ischemia

OBJECTIVE: To investigate the effect of electroacupuncture(EA) of acupoints Neiguan(PC 6) and Tianquan(PC 2) on the skin temperature, blood perfusion, and alpha1-and beta2-adrenoreceptor(α1-AR and β2-AR) protein and m RNA level in rats with acute myocardial ischemia.METHODS: Thirty male adult Wistar rats [(230 ±20) g] were randomly assigned into five groups(n = 6 each): a control group, sham operation group, model group, model group treated with EA at low frequency(L-EA, 2 Hz, 1 m A) and model group treated with EA at high frequency(H-EA, 100 Hz, 1 m A). The rat model was prepared by ligating the left anterior descending coronary artery. Electroacupuncture was performed at the left Neiguan(PC 6) for 20 min daily for 3 d. After the 3 rd time of the treatment, measurements of skin blood perfusion and temperature in Neiguan(PC 6) and Tianquan(PC 2) in all groups were made by laser speckle contrast imaging and infrared thermal image instrument. Real-time PCR and ELISA were used to measure m RNA level and protein level of α1-AR andβ2-AR in the skin tissues of Neiguan(PC 6) and Tianquan(PC 2), respectively. Serum levels of c Tn T and electrocardiogram were used to identify the state of myocardium.RESULTS: In the group receiving electroacupunture at Neiguan(PC 6), compared with control group,the skin temperature, blood perfusion, and β2-AR m RNA and protein level of model group significantly decreased(P < 0.05), α1-AR m RNA and protein level of model group significantly increased(P < 0.05);compared with model group, the skin temperature,blood perfusion, and β2-AR m RNA and protein level of L-EA significantly increased(P < 0.05), α1-AR m RNA and protein level of L-EA and H-EA significantly decreased(P < 0.05). The same trend has taken place in the former four groups of the Tianquan(PC 2).CONCLUSION: Low-or high-frequency electroacupuncture can improve the skin temperature and blood perfusion which may be induced by decreasingthelevelofα1-ARandincreasingthelevelofβ2-AR of the Neiguan(PC 6) and Tianquan(PC 2) in the rat with acute myocaidial ischemia.

Electroacupuncture of Neiguan(PC 6) inhibits enhanced voltage-gated sodium currents in ischemic ventricular myocytes

OBJECTIVE: To examine the effect of electroacupuncture(EA) at bilateral Neiguan(PC 6) on voltage-gated Na+currents(INa) and channels(Nav) in ischemic ventricular myocytes.METHODS: EA serum was prepared from six male adult Sprague-Dawley rats that had received EA at bilateral Neiguan(PC 6). Eighteen ventricular myocytes were prepared from six SD rats using an enzymolysis approach. Myocardial ischemia was mimicked by perfusion of ischemic solution. Whole-cell patch-clamping was used to record three currents evoked from isolated cells. The first current was the control, and recorded in absence of ischemic solution current. The second was the ischemic current,and recorded after perfusion of ischemic solution for 5 min, while the EA current was last, and recorded after perfusion of EA serum for 5 min. Navkinetic curves were fitted using related formulas.RESULTS: Compared with those in controls, in the presence of ischemic solution, peak amplitudes of INasignificantly increased from ﹣40 m V to +30 m V,and half-maximal inactivation potentials of Navincreased significantly, while half-maximal activation potentials, slope factors and the recovery time from inactivation to activation of Navwere unchanged. Compared with those in the ischemic solution, in the presence of EA serum, peak ischemic current amplitudes significantly reduced from ﹣40m V to + 40 m V, and half-maximal inactivation potentials were restored, while half-maximal activation potentials, slope factors and the recovery time from inactivation to activation of Navwere unchanged.CONCLUSION: EA at bilateral Neiguan(PC 6) can reduce enhanced INavia restoration of delayed Navinactivation in ischemic ventricular myocytes.

Effect of transcutaneous electroacupuncture at Neiguan(PC 6) on refractory vomiting in patients in intensive care unit

OBJECTIVE: To observe the effect of transcutaneous electroacupuncture(TEA) at Neiguan(PC 6) on refractory vomiting in critically ill patients in intensive care(ICU) setting.METHODS: Ten patients admitted in ICU and presenting vomiting refractory to one or more antiemetic drugs were prospectively included in the study. TEA was applied at acupoint of Neiguan(PC6) during 30 min with a neuromuscular transmission monitor(single-twitch stimulation with 1 Hz at a constant current of 10 m A). Nausea and Vomiting were evaluated at the following intervals: immediately after 30 min of TEA at Neiguan(PC 6),30 min-6h and 6-24 h. The presence of nausea and/or vomiting throughout the observational period was defined as the primary end point.RESULTS: The presence of nausea or vomiting throughout the observational period was 10% at the end of TEA, 40% between 30 min and 6 h, and50% between 30 min and 24 h(P < 0.001, P = 0.01 and P = 0.03 vs pre-TEA, respectively). There were no complications or side effects related to TEA.CONCLUSION: TEA at Neiguan(PC 6) seems effective in reducing refractory vomiting in the patients in ICU setting, even if larger trials are needed to define optimal modalities.

Influence of Transdermal Electric Stimulation of Neiguan(PC 6)On TCD in Patients with Acute Migraine

Purpose： In order to explore the clinical mechanism of Neiguan （PC 6） in the treatment of acute seizure of migraine and the relationship between Neiguan （PC 6） and cerebral blood flow. Methods： Clinically, 30 cases of the patients with acute seizure of migraine （ascending phase） were selected, in TCD abnormality, and divided randomly into the treatment group and control group, 15 cases in each group. In acute seizure of migraine, Neiguan （PC 6） was punctured with electric stimulation on the healthy side of the patients in the treatment group and Xuehai （SP 10） was punctured with electric stimulation on the healthy side of the patients in the control group. TCD was determined in the patients 30 min before and after the treatment. Results and conclusion： After transdermal electric stimulation on Neiguan （PC 6）, the velocity of intracranial blood flow was obviously slowed down, indicating that transdermal electric stimulation on Neiguan （PC 6） can effectively relieve the spasm of intracranial blood vessels and also shows its relative specificity.

Laterality and coherence analysis of Laser Doppler Flowmetry signals in bilateral Nèi guān(内关 PC 6):a potential non-invasive method to assess microcirculatory changes of people in different ages

Objective To investigate lateralization and Coherence analysis of blood perfusion in bilateral Neiguan （内关 PC 6） in different ages. Methods Healthy volunteers （n=30） were placed in a temperature-controlled room as a resting state for 40 min. Then the blood perfusion of bilateral PC 6 were carried out using PeriFlux System 5000 for 25 minutes. Mean blood flux of every 5 minutes was calculated. Then the participants were divided into groups of young （n=18） and the old （n=12） as the boundary of 40 years, the asymmetry index and coherence value of bilateral PC 6 were analyzed in different group. Results The mean blood flow of the right PC 6 was significantly higher than the left PC 6 in three different epochs, the mean blood flow of right PC 6 vs left PC 6 is 9.74±3.36 vs 6.73±2.22 （t=5.9, P〈0.001）, 9.83±3.63 vs 6.99±2.37 （t=5.11, P〈0.001） and 9.69±3.40 vs 6.77±2.32 （t=5.99, P〈0.001）, respectively. Although the asymmetry index is higher in old group than in young group, there is no statistically significant age-related differences. Coherence analysis suggest that there is significant difference in frequency value corresponding to peak crest between young and old group. Conclusion The blood perfusion in right PC 6 is higher than left PC 6. Coherence analysis of laser Doppler flowmetry signals in bilateral PC 6 might provide a potential non-invasive method to assess microcirculatory changes in different ages.